Analysis of the humoral and cellular response after the third COVID-19 vaccination in patients with autoimmune hepatitis

Abstract

Background & aims: To explore the humoral and T-cell response to the third COVID-19 vaccination in autoimmune hepatitis (AIH). Methods: Anti-SARS-CoV-2 antibody titers were prospectively determined in 81 AIH patients and 53 healthy age- and sex-matched controls >7 days (median 35) after the first COVID-19 booster vaccination. The spike-specific T-cell response was assessed using an activation-induced marker assay (AIM) in a subset of patients. Results: Median antibody levels were significantly lower in AIH compared to controls (10 908 vs. 25 000 AU/ml, p <100 AU/ml) after the second vaccination (N = 11/34) showed a strong, 148-fold increase. Conclusion: A third COVID-19 vaccination efficiently boosts antibody levels and T-cell responses in AIH patients and even seroconversion in patients with the absent immune response after two vaccinations, but to a lower level compared to controls. Therefore, we suggest routinely assessing antibody levels in AIH patients and offering additional booster vaccinations to those with suboptimal responses.